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Home My WebLink AboutPermit Electrical 2007-11-20 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(54I)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number CoM z.c::>o 7 - 0 { 70 I Date 3. 1. IIV1 A-tpv ~70( Sl A. LEGAL DESCRIPTION: 170Z--:$34 ( O"SfD ( JOB DESCRIPTION~" ) V,AII At' \ -'-- Ttw' r .I......b.-..Je>^- rrr,'. ~ ~-'-- ~~ fY}~r, SH-d_-+ {of- Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder $117.00 $ 21.00 Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. $55.00 B. 2. ('Urt ~ "DMI-/ 200 Amps or less 20 I Amps to 400 Amps 401 Amps to 600 Amps 60 I Amps to 1000 Amps Over 1000 AmpsN olts to Rec.~ Onhr_.. taw re~ul'es you. . AI 1C.lmON; Ureyv"b the Oregan Utility .m In OAR 952-001- ie~~ the rules by Oo9msWWttt8U Sl~8T ~dr~.uJne ~~ fir:J6{~go~ Utility Notificayoo $ 55.00 "u.m~Weiki~0~332.2344), $ 76.00 401 Amps to 600 Amps $110.00 $ 70.00 $ 83.00 $138.00 $180.00 $413.00 $ 55.00 Electrical Contractor 5 7 rH s+vr:c/-- 7 f3() So Address City Sf'''>''''} h<.iLy Phone S/1-30 59 155Lf S Supervisor License Number 10// 10'1 I 1 j It 02- \ Expiration Date 5S- Constr. Contr. Number 1/L~ J 0'1 I , Signature of Supervising Electrician >>, y~,.~/- Expiration Date Over 600 Amps or 1000 Volts see "B" above. D. New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit $ 48.00 $ 4.00 Owners Name M L-~A\J S Lc.l'/t..f; Address 2 g'7 b C r(:-SCc.A +- ~ J- City tv-&G-."J~ Phone E. Pump or irrigation $ 55.00 Sign/Outline Lighting w.<:W\C. $ 55.00 OWNER INSTALLATION NO"'Ciki~~~t~f!)l~lBitMi 1~{ \~T $ 28.00 !he in.stallation is being made on property I own which 1\1\S P\if1M ~~~i~~D fO~ $ 50.00 IS not ffitended for sale, lease or rent. f\\MMo.ill .C\S~Ati~~~lOn Fee is $50.00 + Surcharges _ CO~ ~~ AN\{ 8% State Surcharge l( '{O 10% Administrative Fee S-so 5% Technology Fee 'Z?r b 76r Owners Signature: Inspection Request: 726-3769 TOTAL Shared Drive(T:)/Building FormslElectrical Permit Application 7-07.doc CITY OF SPRINGFIELD Building/Combination Permit Status Issued PERMIT NO: COM2007-01701 ISSUED: 11/20/2007 APPLIED: 11/20/2007 EXPIRES: OS/20/2008 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541~726-3769 Inspection Line SITE ADDRESS: 5701 MAIN ST ASSESSOR'S PARCEL NO.: 1702334103101 Springfield TYPE OF WORK: Use Initials TYPE OF USE: New Commercial PROJECT DESCRIPTION: Temp power for xmas tree lot Owner: MCDONALD'S CORP 36-113 Address: 2896 CRESCENT AVE STE 105 EUGENE OR 97408 I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor DONALD MARVIN HORTON License 116021 Expiration Date 07/25/2009 Phone 541- 726-9021 BUILDING INFORMA nON I Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: # of Units: # of Stories: Primary Occupancy Group: Height of Structure Secondary Occupancy Group: Type of Heat: Primary Construction Type Water Type: Secondary Construction j1Y.bIJ:NTION: Oregon rav<<~uto # of Bedrooms: follow rules adopted by tRi~'gGRh1:Itility ~otification Center. Thoseg-~~o mtif~: In OAF! 9S2..p(l1-0010thrnllnh nAR Or:;"_M1._ 0090. You may oL~~Em~Nin!N~'Q~MA TION I calling the cente!" il J"'l.... .I.v .",I",~I,ulIg number for the Oregon Utility Notification Center is 1-80o-3~!S4~Wist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: nla REQUIRED PARKING Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: N OTi (i}&-tnspoutslDrains: THIS PERMIT SHALL EXPIRE IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR .\r,,' 1 ~0 CA. rr:nlUU. . I Valuation Descriotion , Notes: Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Pal!e 1 of 2 Status Iss u ed CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2007-01701 ISSUED: 11/20/2007 APPLIED: 11/20/2007 EXPIRES: OS/20/2008 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project '..,Fees Paid I Fee Description + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Temp Power 200 amps or less Amount Paid Date Paid Receipt Number $5.50 11/20/07 1200700000000001421 $2.75 11120/07 1200700000000001421 $4.40 11/20/07 1200700000000001421 $55.00 11/20/07 1200700000000001421 Total Amount Paid $67.65 I Plan Reviews I To Request an inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. LReouired Insoections I Temporary Electric: Approval required prior to Utility Company energizing pole. By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all times during construction. Owner or Contractors Signature Date Pa2e 2 of 2 225 Fifth Street Sp....ingfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2007-01701 COM2007-01701 COM2007-01701 COM2007-01701 Payments: Type of Payment Check cReceintl RECEIPT #: Description Temp Power 200 amps or less + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By DMH ENTERPRISES City of Springfield Official Receipt Development Services Department Public Works Department 1200700000000001421 Date: 11/20/2007 Item Total: Check Number Authorization Received By Batch Number Number How Received djb 1193 In Person Payment Total: Page 1 of 1 8:56:55AM Amount Due 55.00 2.75 4.40 5.50 $67.65 Amount Paid $67.65 $67.65 11120/2007